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The EHR Paradox - Practice or Vendor Problem?


EHRs are frustrating for physicians. But who's to blame for their lackluster performance?

When you are running a company that had a start and creation shortly before the EHR/stimulus push in the latter half of the previous decade, you uniquely understand where the healthcare industry has traveled.

In fact, you don’t have to go back more than a handful of years to think of a time where electronic health records were seen as the ultimate technology-based solution to drive practices and providers alike into the 21st century.

Unlike other historical, driving innovations, technology is still seen as the limitless possibility between idea and fact. Yet at some point along the way, we are all aware that the allure of EHRs turned into frustrations.

What happened?

Change isn’t easy, and in many cases, the transition happened on the fly for both vendors and practices that were both driven by the promise, and limited in experience and commitment to the partnership (both philosophically and economically), resulting in inevitable failures.

From the beginning of a period that started when the 2009 federal stimulus took effect, this cycle continued time-in and time-out where practices took the plunge with the expectation that EHRs would positively change the way they were practicing, only to find out that their lack of investment internally (and the vendors' cloud-nine visions that technology was its own answer) would doom the transition from day one.

Who’s to blame?

With increasing complexity, and in the wake of the burning tire fire that now represents EHR expectations, it is clear that the traditional way of practicing medicine and the traditional way that technology has been consumed need to be rethought within this ecosystem. The old way does not work for anybody. Both practices and vendors need to rethink the values each need to contribute to a partnership in order to ensure success. Implementing successful EHRs is an extremely sophisticated process that requires both extensive commitment (and knowledge) from both vendors and providers. Let’s examine how we can begin to change this conversation…

It doesn’t take an economist to tell you that the average consumer (see: provider) is looking for a high level of personalization, but at the lowest cost possible. We love when a retailer (see: vendor) takes the extra effort to make us happy, and comfortable, about our purchase. The same could be said for this nation’s practices that were looking for a quick fix to a major problem, with as little investment as possible but with the most highly personalized service expectations. That mismatch spells systemic failure.

Naturally, personalization comes at a premium, producing both vendor and practice failure when price is the deciding factor. The cost of purchasing on price alone proved consistently to be no different than a shell game. What every practice across this great country has to go through is an introspective conversation on the level of commitment both the practice and its vendor have in seeing success through at its true cost.

The vendor space wasn’t exactly a cakewalk either. The stimulus presented a potential financial windfall for many companies that could acquire the right level of sales in an expedient time. It suddenly became the equivalent of a virtual gold rush for vendors looking to seal deals with unrealistic expectations and economics.

In looking back at the prevailing winds that created that scenario, and the existing tensions that are related to both EHRs and the vendor-practice relationship, we should all have an introspective conversation surrounding the personalization and the true cost of it. While there are examples of successes and trends within this spectrum, each practice must consider how its wishes and hopes for personalization play into its collective future and strategies - and how to best match its partnership profile.

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